Faculty of Health Sciences Theses and DissertationsUniversity of Botswana Graduate theses and dissertationshttp://hdl.handle.net/10311/12172024-03-28T17:47:15Z2024-03-28T17:47:15ZExploring the needs of men who have sex with men (MSM) in HIV services in Gaborone city and selected surrounding villages in BotswanaMokgwathi, Simonhttp://hdl.handle.net/10311/24512022-07-27T00:01:28Z2019-12-01T00:00:00ZExploring the needs of men who have sex with men (MSM) in HIV services in Gaborone city and selected surrounding villages in Botswana
Mokgwathi, Simon
There is reliable evidence that men who have sex with men (MSM) are at an increased risk of HIV infection compared to other men of reproductive age. However, there is limited data on the proportion of MSM reached by HIV services globally. This may be compounded by the lack of explicit programmes to curb HIV among MSM. MSM still endure varied forms of stigma and discrimination worldwide, with some countries criminalizing their sexual orientation. In many countries including Botswana, research on MSM is also very low; and there is lack of data on the efforts, risks, challenges and successes in HIV prevention among MSM. The purpose of the proposed study is to explore HIV service needs for men who have sex with men (MSM) in Gaborone and selected surrounding villages in Botswana.
The study will use a qualitative descriptive approach. Data will be collected from MSM and HIV care providers to help explore the specific needs of MSM in HIV services. MSM participants will be sampled through purposive and snowball sampling techniques whereas HIV care providers (which include registered nurses, medical doctors, pharmacy personnel, psychologists and lay counselors) will be sampled using convenience sampling technique. The study will target a total of twenty (20) participants for each group.
The proposed study is guided by Kristen Swanson’s Caring Model. Data will be analyzed using content analysis method. Findings of the study could provide empirical evidence to support advocacy among groups already putting pressure on policy makers to openly address MSM HIV prevention and care; inform health care curricula developers on the critical areas of need in HIV services for MSM, as well as inform organizations providing HIV services on the needs of health care workers in providing quality HIV services for MSM in Botswana.
A dissertation submitted to the School of Nursing, Faculty of Health Sciences, University of Botswana in partial fulfillment of the requirement of the degree of Masters in Nursing Science. Citation: Mokgwathi, S. (2019) Exploring the needs of men who have sex with men (MSM) in HIV services in Gaborone city and selected surrounding villages in Botswana, University of Botswana.
2019-12-01T00:00:00ZA retrospective study of factors associated with intrauterine fetal death in antenatal and labour wards in Princess Marina Hospital in Gaborone, BotswanaMasilo, Gadifele Daphnehttp://hdl.handle.net/10311/20932021-05-12T00:01:08Z2019-07-01T00:00:00ZA retrospective study of factors associated with intrauterine fetal death in antenatal and labour wards in Princess Marina Hospital in Gaborone, Botswana
Masilo, Gadifele Daphne
Introduction
Intrauterine fetal death (IUFD) or stillbirth is stillbirth as fetal death deliveries after 24 completed weeks of gestation with weight of > 500g and does not show any sign of life at any time after delivery. Around 3.2 million of fetal deaths occur per year worldwide, and 98% of these deaths are reported in low and middle income countries. Botswana had stillbirth rate of 16.1 in 1000 births and 6.9 per 1000 births in 2009 and 2014 respectfully.
Underreporting of IUFD cases, improper identification of etiological factors, and lack of uniformity in data collection and classification of causes of fetal death lead to the difficulty in preventing fetal death worldwide. Botswana seems to be amongst the countries that do not have studies that indicate the magnitude of IUFDs. It also seems like the country does not have the health policies, guidelines or protocols that embrace the causes and prevention of IUFDs. Identifying the cause of death enables comparison of national and international health
care, and also assists in identifying prevention measures. It is therefore important that countries like Botswana conduct studies and research on contributing factors towards IUFD in order to generate data about preventable causes, and strategies that can be formed to reduce new incidences in the future.
Purpose of the study
The purpose of this study is to conduct a retrospective analysis of data on patients’ files in order to identify antepartum and intrapartum factors contributing towards IUFD at antenatal and labour wards in PMH.
Method
A quantitative retrospective descriptive institution based study will be conducted by reviewing all records of mothers who had IUFDs/stillbirths in antenatal ward and labour ward in Princess Marina Hospital (PMH) from January 2013 to December 2018. Around 1518 patient records of mothers who had intrauterine fetal death/stillbirth will be reviewed. Data collection form will be used to extract information on possible factors contributing to IUFD such as maternal factors, socioeconomic factors, management factors, socioeconomic factors, management factors, labour and delivery factors, demographic factors, fetal factors, placental and umbilical factors.
Sample size
All records of mothers who had IUFDs/stillbirths (around 1518) from 2013 to 2018 will be reviewed in this study.
Selection
Convenience sampling will be used to select all the records of mothers who had IUFD/stillbirth from antenatal and labour wards for in PMH.
A dissertation submitted to the School of Nursing, Faculty of Health Sciences, University of Botswana in partial fulfilment of the requirement of the degree of Masters of Nursing Science. Citation: Masilo, G.D. (2019) A retrospective study of factors associated with intrauterine fetal death in antenatal and labour wards in Princess Marina Hospital in Gaborone, Botswana, University of Botswana
2019-07-01T00:00:00ZClinical experiences of health care workers caring for drug resistant Tuberculosis patients at Princess Marina Hospital, GaboroneStegling, Nkgadimanghttp://hdl.handle.net/10311/20922021-05-12T00:00:39Z2018-01-01T00:00:00ZClinical experiences of health care workers caring for drug resistant Tuberculosis patients at Princess Marina Hospital, Gaborone
Stegling, Nkgadimang
Background: Tuberculosis (TB) remains a major global health problem and ranks alongside HIV/AIDS as the top infectious killer worldwide, with 9.6 million new cases and 1.5 million deaths estimated to have occurred in 2014. Drug-resistant TB (DR-TB) threatens the global TB control and is a major public health concern in several countries. Botswana has one of the world’s highest burdens of TB per capita with a TB notification rate currently placing Botswana as 10th highest worldwide. The literature reviewed revealed that health care settings lack adequate or effective infection control measures thereby predisposing health care workers (HCWs) to TB infection and that they have poor health seeking behaviour hence poor access to TB/HIV treatment. In Botswana, there is limited data regarding the prevalence nor the incidence of TB amongst HCWs and their experiences in caring for DR-TB patients. Purpose: The purpose of this study is to explore experiences of HCWs during the provision of care to patients diagnosed with DR-TB at Princess Marina Hospital, Gaborone. Methods: The study will utilise a descriptive phenomenological qualitative research design and non-probability purposive sampling will be used. Semi-structured in-depth interviewing will be used to collect data and it will be analysed using Collaizi (1978) phenomenological analytic method. NVivo software will be used to analyse the clusters of themes emerging from the data. Findings: The study findings will assist HCWs to modify infection control practices to minimise the risks in health care settings. It is envisaged that this would ultimately improve their health care.
A dissertation submitted to the Dept. of Nursing, Faculty of Health Sciences, University of Botswana in partial fulfilment of the requirement of the degree of Master of Nursing Science. Citation: Stegling, N. (2018) Clinical experiences of health care workers caring for drug resistant tuberculosis patients at Princess Marina Hospital, Gaborone, University of Botswana
2018-01-01T00:00:00ZClinical outcomes of patients with rifampicin resistant other than multi-drug resistant tuberculosis in Botswana; a 2006-2014 retrospective cohort analysisKuate, Lesegohttp://hdl.handle.net/10311/20752021-03-19T00:00:33Z2019-06-07T00:00:00ZClinical outcomes of patients with rifampicin resistant other than multi-drug resistant tuberculosis in Botswana; a 2006-2014 retrospective cohort analysis
Kuate, Lesego
Background
Rifampicin resistant tuberculosis (RR-TB) cases were historically managed using different drug-regimen depending on the resistance patterns. RR-TB other than MDR-TB were treated using modified regimen (first-line regimen plus fluoroquinolone +/-amikacin). World Health Organization (WHO) recommended that all cases of RR-TB should be treated using standardized Multi-drug-resistance TB (MDR-TB) regimen since rifampicin resistance (RR) is always accompanied by isoniazid resistance (INH). However recent evidence has shown otherwise and WHO stated that country-specific data should be examined to determine the relationship between rifampicin and isoniazid resistance. The recommendation to treat all cases of RR-TB as MDR-TB cases might not be relevant in our setting since the former practice have not been evaluated.
Aim
To evaluate the clinical treatment strategies amongst patients with rifampicin resistance other than MDR and their impact on treatment outcomes from 2006-2014
Objectives
- To determine the prevalence of RR-TB with concomitant INH resistance among RR-TB cases
Objectives
- To determine the prevalence of RR-TB with concomitant INH resistance among RR-TB cases
- To determine the clinical outcomes of RR-TB other than MDR-TB patients based on different treatment regimens
- To determine the risk factors for unfavorable outcomes of patients with RR-TB other than MDR-TB
Methodology
A retrospective cohort study was carried out involving the review of data of all RR-TB cases as per microbiologic confirmation from 2006 to 2014. Patients with resistance to second-line drugs and children (<15years old) were excluded. A proportion of RR-TB with concomitant INH resistance was calculated. Treatment outcomes were categorized as favorable and unfavorable. The former if patients were cured or completed treatment and unfavorable if they had treatment failure, loss to follow-up or death. Multivariate logistic regression model was used to determine predictors of unfavorable outcomes.
Results
One thousand one hundred and thirty six (1 136) cases of RR-TB were recorded from 2006 to 2014. The proportion of cases of RR with concomitant INH resistance varied by years, ranging from 61% to 90% across the years, the average being 79%. Out of two hundred and sixteen RR-TB other than MDR-TB patients, 79.6% (172/216) had the treatment outcome records and were included in the analysis. Of those, 66.3% (114/172) patients were initiated on first-line regimen, 20.3% (35/172) on modified regimen and 13.4% (23/172) on standardized MDR-TB regimen. The mean length of treatment was 222 (+/- 93) days) for first line regimen, 447 (+/- 177) for modified regimen and 568 (+/- 219) for MDR-TB regimen. There was no statistically significant difference in unfavorable outcomes across the three treatment groups; first-line regimen, MDR-TB and modified regimen with 27% (31/114), 22% (5/23) and 17% (6/35), respectively, Pearson chi square, 1.6, P = 0.456. However, 8% (9/114) treatment failure and 10% (11/114) relapse were found only among those treated with the first-line regimen. The study did not find any statistically significant predictors for unfavorable outcomes.
Conclusions
Rifampicin resistance may be a reliable proxy for MDR-TB in a significant number of cases in Botswana due to a high proportion of RR-TB with concomitant INH resistance. Though the overall treatment outcome was similar among the three regimens used, because of the potential risk of treatment failure and relapse, modified regimen and MDR-TB regimen appear to be treatment of choice in our setting.
A dissertation submitted to the Department of Family medicine and Public Health, Faculty of Medicine, University of Botswana in partial fulfilment of the requirement of the degree of Master of Medicine in Public Health. Citation: Kuate, L. (2019) Clinical outcomes of patients with rifampicin resistant other than multi-drug resistant tuberculosis in Botswana; a 2006-2014 retrospective cohort analysis, University of Botswana.
2019-06-07T00:00:00Z